Nutrition and TB are two entities which need to be considered together, not separately. It is unfortunate that our country has not taken any initiative in this area resulting in a disregard for this relationship. If we really want to overcome TB, we need to talk through a package system similar to what the market does. For TB to be controlled, we need to make sure that nutrition is an essential part of the treatment as a basic means to fight against this disease.
TB targets mostly poor people, a disease of the poor in society. The reason behind it is not that it targets people in lower financial circumstances. But, lacking adequate finances, most poor families cannot afford good nutritious food. Over time, being underfed, their immune systems become too weak to fight off disease. Most of the people are not aware of the fact that they are under siege, by infectious bacteria, which eventually causes TB to attack their bodies.
Half the population of adults in Pakistan walk around with an inactive TB infection. The bacteria wait for the right time to strike. They become active when the immune system of a person’s body is weakened mainly by under-nutrition, HIV infection, diabetes or old age.
Malnutrition is an important factor which plays a vital role in activating the latent TB bacteria. It targets malnourished children with weak immune systems. Pakistan is a country where 42 percent of children below 5 years of age are malnourished. Malnourished children are the most vulnerable, having the highest rate of being targeted by TB. Every malnourished child may be a victim of TB. Considering these factors, it makes more sense in putting more efforts into identifying and diagnosing TB in children.
In 56 countries where most cases of TB and mal-nourishment have been detected, have introduced nutrition as a compulsory component in their TB control program. Half of these TB patients were severely enmeshed in the throes of food insecurity. The WHO is developing guide lines on nutritional needs and support for TB patients. WHO considers nutrition an essential part of treatment.
After considering all the evidence and research available, the government now has an opportunity to foster a strong will to work on nutrition and TB together. TB affected families can be given priority and provided with nutritional security.
This is a critical task as 70 percent of the total population survives on below 20 rupees a day. A balanced diet for all is a far cry off. And in the absence of a balanced diet, overcoming TB would be an impossible task. Insufficient food has been shown as the main reason behind half of TB infections. The situation gets worst with malnourished children. Field squads working at the grass roots level, have neither appropriate guide lines nor a capacity to understand this fundamental relationship of bad nutrition and TB.
It is incumbent on the government to clearly define for the public, the relationship between TB and malnutrition. Programs need to be speeded up so that the present generation of children can be safeguarded and their futures ensured. It is an issue that should be addressed as soon as possible.